Juan Villarroel, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0061445 Issued in FL

Practice address

4850 W Oakland Park Blvd Ste 148
Lauderdale Lakes, FL 33313-7277

Phone

(954) 735-1200

NPI assigned

May 20, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conviva Medical Center Management LLC

  dba Conviva Care Center

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment NPD
• Northwest Medical Group, LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1679794986
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174577506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 148",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137277",
            "telephone_number": "954-735-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 NW 17th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331427655",
            "country_code": "US",
            "telephone_number": "305-635-0335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARROEL",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0061445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME0061445",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373244400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andre Vicuna Blanco, BCBA
• Ramon Vidal, MD
• Stephanie Vietinghoff, MSN AGACNP
• Stephanie Franchesca Villadamigo, ARNP
• Ruben Villarreal, DMD
• Jason G Volbrecht, PTA
• Lori P Voss, PA-C
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3625)
• Wal-Mart Stores East, LP (Vision Center 30-3625)
• Jody Ilene Walden

• Internal Medicine Physician in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.